Korean Journal of Pediatrics 2005;48(9):991-997.
Published online September 15, 2005.
Risk Factors for the Early Recognition of Cow's Milk Protein-induced Enterocolitis
Sung Hyuk Lee1, Seon Yun Choi1, Byung Cheol Lee1, Won Joung Choi1, Byung Kyu Choe1, Yeo Hyang Kim1, Una Kang2, Sin Kam3, Jin-Bok Hwang1
1Departments of Pediatrics, Keimyung University School of Medicine, Daegu, Korea
2Departments of Pathology, Keimyung University School of Medicine, Daegu, Korea
3Department of Preventive Medicine , Kyungpook National University School of Medicine, Daegu, Korea
우유 단백질 유발성 장염의 조기진단을 위한 위험인자
이성혁1, 최선윤1, 이병철1, 최원정1, 최병규1, 김여향1, 강유나2, 강신3, 황진복1
1계명대학교 의과대학 소아과학교실
2계명대학교 의과대학 병리학교실
3경북대학교 의과대학 예방의학교실
Jin-Bok Hwang, Email: pedgi@korea.com
: Cow's milk protein-induced enterocolitis(CMPIE) is a symptom complex of vomiting and/ or diarrhea caused by delayed hypersensitivity and may result in serious complications. This study was undertaken to identify high risk factors to facilitate the early recognition of CMPIE.
: We reviewed the data of 101 patients, aged 15 to 45 days, admitted due to vomiting and/ or diarrhea between 2003 and 2004. After excluding 13 patients absolutely breast-fed and 2 patients transferred from other hospitals with the impression of CMPIE, the 86 study subjects were divided into three groups based on the underlying etiologies; CMPIE, infectious and non-infectious group.
: CMPIE was diagnosed in 11 patients(12.8%). On admission, failure to gain weight(P= 0.003), hypoalbuminemia(P=0.003), peripheral leukocytosis(P=0.015), and metabolic acidosis(P=0.014) were more significant in the CMPIE group than in the others. Multiple logistic regression analysis showed that the independent predictors of high risks for CMPIE were failure to gain weight <10 g/day(OR, 10.25[95% CI, 1.62-65.06]) and serum hypoalbuminemia <3.5 g/dL(OR, 9.18[95% CI, 1.69- 49.74]). Cow's milk challenges were performed in the 11 CMPIE patients; vomiting(81.8%), abnormal stool test(80.0%), peripheral leukocyte count and absolute neutrophil count(ANC) increase(100.0%) (P<0.05), and enteropathy(100.0%).
: CMPIE is not a rare clinical disease in early infancy. The high risk factors of CMPIE were identified as follow : failure to gain weight below 10 g/day, hypoalbuminemia on admission and a rapid decrease during admission. Cow's milk challenge test with endoscopic duodenal biopsy was helpful to confirm CMPIE.
Key Words: Cow's milk protein-induced enterocolitis , Risk factor

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